Rise and spine! Dr. Holman and I began our chilly Monday morning at 5:30am with a mind-focusing (or simply exhausting) P90X yoga routine. A quick team breakfast followed and it was off to the hospital to begin week two. Nadia was offered to sit out for the day and rest after her boda-boda motorcycle beat down yesterday, but being the champ that she is, she didn’t even consider it an option. Talk about a team player! With two surgeries lined up for the day, we finished rounds rather quickly and got into the OR at 10am, only stopping briefly by the CT room to burn new images (Dr. Holman’s computer had eaten the original CD). Our first case of the day was the trauma patient we met on Friday, Namu, who had a jumped facet (dislocated joint) in his cervical spine. We performed a complication-free anterior cervical discectomy and fusion on him. During the turnover of the OR for our next case, I walked outside to catch a cool breeze and visit the ward. We hadn’t seen Frank during our morning rounds and I felt the need to check up on him (always a highlight of my day). Earlier during the trip, a nurse mentioned that Frank had seen some boys playing with new soccer balls around the hospital and had asked her where they had gotten them. I knew that the affable first spinal team had given some out and I was relieved to find an extra in the storage room for Frank! He loved it!

“For me?” –Frank

Back in the OR the second case of the day had already begun, along with Dr. Holman’s 80’s Mega Collection playlist (The Doobie Brothers and spine surgery is quite the combination)! Both Dr. Holman and Dr. Burch were meticulously operating on young Naomie with Kyphosis, attempting to decompress the apex of her curved spine and straighten up her forward ‘hunch’. The surgery pushed the teams knowledge and coordination to a new level. Fluctuation in motor-responses and rolling power outages were among the few hiccups we encountered. However, after six hours of surgery, we closed up with confidence. At 10:15pm, we left the hospital and grabbed an Agip hotel fish kabob to fuel our empty tanks and it was off to bed. Sleep, spine, eat, repeat! Day 9: This morning the team spent some time discussing the incredible pathology that we’ve encountered here in Uganda and how this pathology translates into the strenuous surgeries we’re performing. Dr. Burch thoroughly explained the risks associated with these corrective operations, but also pointed out the fact that in many instances, the patients we’ve seen who’ve neglected having surgery have presented with paralysis. With surgery there’s a chance at a normal life. Without surgery early on in a deformities development, the complexity of the procedure needed will escalate and the chance of permanent neurological deficit will upsurge. With these words of wisdom, we finished our breakfast and went to the hospital. Rounds jump-started our day. Namu, the trauma patient from yesterday, is doing well this morning and already wants to know when he’s free to leave the wards. He’s got at least one recovery day and some discharge instructions ahead of him. Naomie’s feeling weak in her legs after her operation yesterday, but we hope and predict that she’ll gradually regain her strength. Dr. Deo found us in the ICU and asked if we’d take a look at an ER patient who arrived yesterday. Edson was presenting a loss of motors and sensation in his legs after lifting a heavy load. A quick scan of his x-rays revealed a burst fracture in his lower back… “take him to the OR!” Dr. Burch explained to me that an injury like this needs to be treated immediately to increase the chance of restoration of feeling and movement in the legs. The surgery, a five level fusion, went smoothly and felt like a walk in the park after all of the rare deformity cases we’ve completed. Our plan was to perform a second surgery in the afternoon, but an extended power outage stopped us from turning over the instruments that we would need. Instead, we made rounds in the ER before heading back to the resort for the night. The team ate dinner, stayed up sharing stories for hours, and went to bed hoping the power would be back up at the hospital in the morning enabling a more productive day. Quote of the day: “So now you guys are going to start working on that humpdy hump?” –Rob said while pointing at Naomie’s Kyphosis apex.